JEFFREY JOSEPH GRONKIEWICZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056851

License Status

CANCELLED

Business

Title

First Name

JEFFREY

Middle

JOSEPH

Last Name

GRONKIEWICZ

Business Name

JEFFREY JOSEPH GRONKIEWICZ MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

06/07/2012